Osoba D, Zee B, Warr D, Latreille J, Kaizer L, Pater J
British Columbia Cancer Agency, Vancouver, Canada.
Support Care Cancer. 1997 Jul;5(4):307-13. doi: 10.1007/s005200050078.
The purpose was to measure the effects of postchemotherapy nausea and vomiting (PCNV) on health-related quality of life (HQL) in patients receiving either moderately or highly emetogenic chemotherapy. The study sample consisted of 832 chemotherapy-naive patients with cancer who received either moderately or highly emetogenic chemotherapy as part of multicenter trials of new antiemetics. The patients completed the self-report European Organization for Research and Cancer (EORTC) core Quality of Life Questionnaire (QLQ-C30) before chemotherapy (baseline) and 1 week (day 8) and 2-4 weeks after chemotherapy. They also completed a self-report nausea and vomiting (NV) diary for 5-7 days after chemotherapy. To determine the effects of PCNV on HQL, the change in scores between the baseline and day 8 HQL assessments was calculated for each domain and symptom in the QLQ-C30 and compared in four subgroups of patients: those with both nausea and vomiting, those with nausea but no vomiting, those with no nausea but with vomiting, and those with neither nausea nor vomiting. The group with both nausea and vomiting showed statistically significantly worse physical, cognitive and social functioning, global quality of life, fatigue, anorexia, insomnia and dyspnea as compared to the group with neither nausea nor vomiting (0.0001 < P < 0.05). Patients with only nausea but no vomiting tended to have less worsening in functioning and symptoms than those having both nausea and vomiting. Increased severity of vomiting (> 2 episodes) was associated with worsening of only global quality of life and anorexia as compared with 1-2 episodes of vomiting (0.0001 < P < 0.01). By 2-4 weeks after chemotherapy all HQL scores had either returned to their baseline levels or were better than baseline. PCNV adversely affects several quality-of-life domains, but patients with only nausea experience less disruption than do those with both nausea and vomiting. Patients with 1-2 episodes of vomiting experience almost the same degree of disruption of HQL as do patients with more than 2 episodes of vomiting.
本研究旨在衡量接受中度或高度致吐性化疗的患者化疗后恶心呕吐（PCNV）对健康相关生活质量（HQL）的影响。研究样本包括832例初治癌症患者，他们接受中度或高度致吐性化疗，作为新止吐药多中心试验的一部分。患者在化疗前（基线）、化疗后1周（第8天）以及化疗后2 - 4周完成了自我报告的欧洲癌症研究与治疗组织（EORTC）核心生活质量问卷（QLQ - C30）。他们还在化疗后5 - 7天完成了一份自我报告的恶心呕吐（NV）日记。为了确定PCNV对HQL的影响，计算了QLQ - C30中每个领域和症状在基线和第8天HQL评估之间的得分变化，并在四组患者中进行比较：同时有恶心和呕吐的患者、有恶心但无呕吐的患者、无恶心但有呕吐的患者以及既无恶心也无呕吐的患者。与既无恶心也无呕吐的组相比，同时有恶心和呕吐的组在身体、认知和社会功能、总体生活质量、疲劳、厌食、失眠和呼吸困难方面在统计学上显著更差（0.0001 < P < 0.05）。仅有恶心但无呕吐的患者在功能和症状方面的恶化程度往往低于同时有恶心和呕吐的患者。与呕吐1 - 2次相比，呕吐严重程度增加（> 2次发作）仅与总体生活质量和厌食的恶化相关（0.0001 < P < 0.01）。化疗后2 - 4周，所有HQL得分要么恢复到基线水平，要么优于基线。PCNV对几个生活质量领域有不利影响，但仅有恶心的患者比同时有恶心和呕吐的患者受到的干扰更少。呕吐1 - 2次的患者与呕吐超过2次的患者在HQL方面受到的干扰程度几乎相同。
